Atherosclerotic renovascular disease as a cause of end-stage renal disease: cost considerations.

Atherosclerotic vascular disease affects an increasing number of patients with end-stage renal disease. A review of comorbid atherosclerotic disease in 7,200 end-stage renal disease patients indicated that occlusive disease of the renal arteries may contribute to progressive renal failure in 1.34% of the US dialysis population or in 14% of the Caucasian patients with hypertensive nephrosclerosis. The costs of dialytic care in such patients exceed USD 87 million annually. The risks and costs of surgical revascularization of such patients are large, however. These data argue that prospective trials of intervention in atherosclerotic renal artery disease are urgently needed.